Feline Diabetes Monitoring Fact Sheet
This fact sheet explains how we monitor the treatment and progress of cats diagnosed with diabetes mellitus.
How will my diabetic cat’s treatment be monitored?
A combination of monitoring by regular check ups with your vet and on-going monitoring at home is required.
What will my vet monitor?
Initial monitoring of diabetes can involve relatively regular check-ups at the vets and relatively regular blood tests. This is to ensure both that the dose of insulin is sufficient in order to control the disease, and also that your cat’s blood sugar is not going too low. As the diabetes becomes more stable, check-up schedules can reduce to as little as 3-4 times per year, but some patience is required prior to reaching this stage.
Monitoring of diabetes is done in a number of ways. By far the most important monitoring is of the clinical signs of the disease. If a diabetic cat is eating well, not drinking excessively and maintaining a stable body weight then the diabetes is almost certainly adequately controlled. As such, the most important thing you can do at home is monitor your cat for these things so you can give the information to your vet. Keeping a diary can be a very helpful tool to enable this.
Another monitoring tool is called the glucose curve. These are often performed at the vets, but in time can be performed at home with the correct equipment if owners so desire. Glucose curves help to show what happens to the blood sugar after a dose of insulin is given, and these are most useful in the initial stabilisation stage and when the diabetes doesn’t appear to be well controlled. In the case of poor control, the curve can provide important information to explain why this I the case.
Other commonly used methods include a blood parameter called fructosamine. Fructosamine is a measure of average blood sugar over the previous 1-3 weeks, and can therefore give an overall impression of whether the blood sugar is on average too high or too low. This is very useful in combination with clinical signs, and can be used to detect the onset of diabetic remission as well as an indicator of sub-optimal management.
What can I monitor at home?
Once you are comfortable with the process of injecting insulin twice daily, some owners feel able to trial at-home monitoring of blood glucose. This can be done in two ways. The first is with a handheld veterinary ‘glucometer’. This measures the glucose in a tiny drop of blood generated by using a lancet (similar to those used for cholesterol testing or iron testing in human medicine) on a pad or the inside of an ear. This is typically very well tolerated by patients, and taking samples at home can save the need to go to the vet practice for a glucose curve. The added benefit is that glucose measurements at home can provide a much more accurate picture of the response to insulin than those is in the hospital.
The alternative is a ‘flash glucose monitor’. These are the same as the monitors used by diabetic people to check their blood sugar before and after meals. These are made up of a sensor, which is stuck onto the skin on the back of the neck, and a hand-held reader (or smartphone). Once fitted, the sensor can stay in place for two weeks and readings can be taken as often as required without the need to use a lancet.
Less intense home monitoring can also be carried out using urine dipsticks. These can show whether there is glucose or ketones in the urine, and is a relatively crude estimate of diabetic control. However, in cats where financial constraints prevent more intense monitoring, weekly urine tests can give a rough estimate as to whether the insulin dose is too high, and combined with monitoring of clinical signs are able to fulfil some of the monitoring requirements.
Home monitoring is never a substitute for advice from your vets, and when measurements are taken they should be given to your vet to interpret. Glucose measurements vary hugely on a daily basis, with some high readings inevitable even in the best controlled cats. As such, no decisions to change insulin dose should ever be made without consultation with a veterinary surgeon.
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